ANCC FNP EXAM PREP 2026-2027
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with a sudden onset of excruciating eye pain, blurred vision,
and seeing halos around lights. On examination, the eye is red, the cornea is cloudy, and the
pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Primary open-angle glaucoma
B. Acute angle-closure glaucoma
C. Bacterial conjunctivitis
D. Retinal detachment
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden eye pain, halos, and a mid-dilated pupil. Open-angle glaucoma is
typically asymptomatic until late stages.
,2. According to the JNC 8 and updated AHA/ACC guidelines, which of the following is the first-
line treatment for an African American patient with hypertension without chronic kidney
disease?
A. Thiazide diuretic or Calcium Channel Blocker
B. ACE inhibitor or ARB
C. Beta-blocker
D. Alpha-blocker
Answer: A
Conceptual Explanation: For the general African American population, thiazide-type
diuretics or calcium channel blockers are recommended as initial therapy.
3. A 24-year-old female presents with a ‘strawberry cervix’ and a malodorous, frothy, yellow-
green vaginal discharge. Which diagnostic test is the gold standard for this condition?
A. NAAT (Nucleic Acid Amplification Test)
B. KOH prep looking for pseudohyphae
C. Whiff test
D. Tzanck smear
Answer: A
Conceptual Explanation: The symptoms describe Trichomoniasis. While wet mounts are
common, NAAT is considered the gold standard for high sensitivity and specificity.
, 4. A patient with a history of COPD presents with increased sputum production and dyspnea.
Which of the following is the most appropriate initial pharmacological treatment for a Grade
B COPD patient according to GOLD guidelines?
A. Long-acting muscarinic antagonist (LAMA) or Long-acting beta-agonist (LABA)
B. Short-acting beta-agonist (SABA) only
C. Inhaled corticosteroid (ICS) monotherapy
D. Theophylline
Answer: A
Conceptual Explanation: GOLD Group B patients should be started on a long-acting
bronchodilator (LAMA or LABA). ICS is not used as monotherapy in COPD.
5. A 45-year-old female reports a ‘curtain falling’ over her vision in the left eye. She has no
pain. What is the priority intervention?
A. Prescribe lubricating eye drops
B. Refer immediately to an ophthalmologist for suspected retinal detachment
C. Perform a tonometry test for glaucoma
D. Treat for giant cell arteritis with steroids
Answer: B
QUESTIONS AND ANSWERS
1. A 65-year-old male presents with a sudden onset of excruciating eye pain, blurred vision,
and seeing halos around lights. On examination, the eye is red, the cornea is cloudy, and the
pupil is mid-dilated and non-reactive. What is the most likely diagnosis?
A. Primary open-angle glaucoma
B. Acute angle-closure glaucoma
C. Bacterial conjunctivitis
D. Retinal detachment
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is a medical emergency
characterized by sudden eye pain, halos, and a mid-dilated pupil. Open-angle glaucoma is
typically asymptomatic until late stages.
,2. According to the JNC 8 and updated AHA/ACC guidelines, which of the following is the first-
line treatment for an African American patient with hypertension without chronic kidney
disease?
A. Thiazide diuretic or Calcium Channel Blocker
B. ACE inhibitor or ARB
C. Beta-blocker
D. Alpha-blocker
Answer: A
Conceptual Explanation: For the general African American population, thiazide-type
diuretics or calcium channel blockers are recommended as initial therapy.
3. A 24-year-old female presents with a ‘strawberry cervix’ and a malodorous, frothy, yellow-
green vaginal discharge. Which diagnostic test is the gold standard for this condition?
A. NAAT (Nucleic Acid Amplification Test)
B. KOH prep looking for pseudohyphae
C. Whiff test
D. Tzanck smear
Answer: A
Conceptual Explanation: The symptoms describe Trichomoniasis. While wet mounts are
common, NAAT is considered the gold standard for high sensitivity and specificity.
, 4. A patient with a history of COPD presents with increased sputum production and dyspnea.
Which of the following is the most appropriate initial pharmacological treatment for a Grade
B COPD patient according to GOLD guidelines?
A. Long-acting muscarinic antagonist (LAMA) or Long-acting beta-agonist (LABA)
B. Short-acting beta-agonist (SABA) only
C. Inhaled corticosteroid (ICS) monotherapy
D. Theophylline
Answer: A
Conceptual Explanation: GOLD Group B patients should be started on a long-acting
bronchodilator (LAMA or LABA). ICS is not used as monotherapy in COPD.
5. A 45-year-old female reports a ‘curtain falling’ over her vision in the left eye. She has no
pain. What is the priority intervention?
A. Prescribe lubricating eye drops
B. Refer immediately to an ophthalmologist for suspected retinal detachment
C. Perform a tonometry test for glaucoma
D. Treat for giant cell arteritis with steroids
Answer: B
